Really concerned about insurance situation... — The Bump
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Really concerned about insurance situation...

I'm going to keep the background short... Insurance plans offered by my employer are determined by the state I live in.  My state is broke, and this year, they decided to only offer two plans--

Option 1: Affordable, but only available in 38 counties in the state.  My county is not one of them, and thus, I am not allowed to choose it.

Option 2:  Childbirth will cost more than 10 times the amount I expected to pay.

 My current insurance carrier is one of the ones on the chopping block. 

On the plus side, the 200,000+ workers affected by this change raised hell and now the state granted a 90-day extension on last year's plans.

The downside?  The 90-day extension will expire five days before my due date.  The legislators will convene shortly before the extension expires.  

I'm worried about the worst case scenario, which is that the state chooses to drop all insurance companies except options 1 and 2, I apply for continuity of care with option 2 (which I have to do since I'm switching carriers mid-pregnancy), give birth before my application is approved, and the entire birth, hospital stay and well-baby care in the hospital are not covered.  I'm at a loss.  I DO NOT want to be induced without medical reason.  Does anyone have any advice?

Re: Really concerned about insurance situation...

  • I don't know if it will be the same for you but DH is changing jobs and they told me his current insurance covers up to the birth and then after labor and delivery the new picks up. You might call and see if that is how yours is going to work.
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  • how far along are you?  are you birthing in a hosp/birth center or home?  how much is it going to cost?  have you called the company to ask them what your options are, where is your info coming from?   if you are using a hospital, can you just work out a payment plan with them after the birth? 

    i need more info!

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  • I'm 26 weeks.  I plan to birth in a hospital.  I called the company I may be forced to switch to--they're the ones who told me I'd have to apply for continuity of care.  The doctor will charge around $3,900, the hospital, anywhere from $10,000 on up depending on how much intervention is necessary.
  • What about a supplemental insurance plan? I don't know much about them, but it might be something to look into. 
  • imagejpsquared:
    I'm 26 weeks.  I plan to birth in a hospital.  I called the company I may be forced to switch to--they're the ones who told me I'd have to apply for continuity of care.  The doctor will charge around $3,900, the hospital, anywhere from $10,000 on up depending on how much intervention is necessary.

    Can you find out if your application for continuity of care is pending at the time of admission and you are later approved whether the approval is retroactive to the time that you filed the application?  Or only applicable effective the approval date? 

    Also - is there anything you can do to start the process now or do you have to wait until your current insurance is actually terminated?

     

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  • imagejpsquared:
    I'm 26 weeks.  I plan to birth in a hospital.  I called the company I may be forced to switch to--they're the ones who told me I'd have to apply for continuity of care.  The doctor will charge around $3,900, the hospital, anywhere from $10,000 on up depending on how much intervention is necessary.

    Can you find out if your application for continuity of care is pending at the time of admission and you are later approved whether the approval is retroactive to the time that you filed the application?  Or only applicable effective the approval date? 

    Also - is there anything you can do to start the process now or do you have to wait until your current insurance is actually terminated?

     

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  • I think the issue for me is the timing.  The possibility that I won't know my insurance situation be until a few days before I deliver, AND will lose my current carrier.  In that case, I will need to coordinate coverage in the 11th hour. That's worst case.  If that happens, I'll be scrambling.

    Of course, there's always the possibility that I will deliver early.  Or, legislators will extend the current plans for another two years (that bill is on the table right now and will be decided upon right around the deadline).  Or, legislators may be at a standstill for weeks after I deliver, and will keep pushing back the end date of the insurance extension.  In both of those cases, my current insurance carrier will cover everything and I'll be fine. 

    It's kind of that "holy ***, my insurance just got cancelled and I have a few days to figure things out and hope I don't go into labor in the mean time" situation that I'm freaking out about.  I know that sounds paranoid, but literally, that's how I got the news earlier this month that my insurance carrier was being dropped.  We had until June 17 to select an insurance carrier.  The Thursday a week before that (June 9), DH and I went out of town.  That Friday, (while out of town) I read an article about a judge placing an emergency halt on this year's insurance plans and thought "hmm what does that mean?"  Then the next Monday (still out of town), I got an email from my company's HR that said the state had dropped all plans except the two I mentioned earlier and we had five days to make a decision or be defaulted into one of them.

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